Form 6—Application for provisional arrest warrant
Commonwealth of Australia
International Criminal Court Act 2002
Application under subsection 21(2) for provisional arrest warrant
To a magistrate:
I, [insert name of applicant and the capacity in which application is made], apply under subsection 21(2) of the International Criminal Court Act 2002 (the Act) on behalf of the International Criminal Court for issue of a warrant, according to a notice under subsection 21(1) of the Act, for the provisional arrest of [insert name of person].
2. The request for provisional arrest shall be made by any medium capable of delivering a written record and shall contain:
(a) Information describing the person sought, sufficient to identify the person, and information as to that person's probable location;
(b) A concise statement of the crimes for which the person's arrest is sought and of the facts which are alleged to constitute those crimes, including, where possible, the date and location of the crime;
(c) A statement of the existence of a warrant of arrest or a judgement of conviction against the person sought; and
(d) A statement that a request for surrender of the person sought will follow.